JCPP Editorial: Volume 62, Issue 04, April 2021

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Senior Editorial Assistant for ACAMH.

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Editorial: ‘The early bird catches the worm’—the need for even earlier intervention and targeted prevention for mental illnesses

Helen L. Fisher

Abstract

Intervening early during childhood and adolescence to prevent mental health problems from becoming chronic, or even to prevent them occurring at all, has become an increasingly popular approach within the field of mental health over the past three decades. The importance of, and potential for, early preventive interventions in infancy, the pre‐natal period and even pre‐conception is highlighted by several of the papers featured in the current issue of the Journal, which are summarised in this editorial. Identifying children most at risk of mental illness in order to selectively target preventive efforts and carefully testing the effectiveness of these interventions, particularly in low‐and middle‐income country contexts, are crucial next steps as we move towards an era of more personalised and earlier prevention and intervention in mental health.

We hope you enjoy the full editorial of this Issue, which is free on the Wiley Online Library.

Dr. Helen Fisher

Helen has spent 18 years researching the aetiology and treatment of psychosis in young people. Her initial research involved evaluating Early Intervention Services for young people with psychosis, and then focused on the role of childhood maltreatment in the development and course of psychosis. During her MQ Fellows award she extended this work to explore the social, psychological and epigenetic factors that increase and decrease the risk of psychotic experiences developing and persisting during adolescence amongst victimised children.

Currently, her research programme examines the role of the wider environment (neighbourhood social factors and air pollution) in the emergence of psychotic phenomena and other mental health problems during adolescence; epigenetic signatures of victimisation and psychosis; the phenomenology of childhood psychotic symptoms; predicting which victimised children will have poor functioning and develop psychopathology in late adolescence; improving public understanding of psychosis through immersive art experiences; and early identification of adolescents at risk for depression around the globe.

She is also a co-investigator of the Environmental Risk (E-Risk) Longitudinal Twin Study and a Research Consultant for the NSPCC.

Discussion

I found this abstract interesting. My MH problems started age 17 after a very unhappy year at college. I suffered extreme acute anxiety episodes since 17-61. I attended a workshop at Cambridge and learned that b/p disorder has ‘roots’ in early childhood trauma. I could easily relate to this as I am a ‘miracle’ surviving baby. I contracted pneumonia at 18 mths which led to whooping cough and my mother was told I would not survive and would die. Thankfully I didn’t but I would love to explore this more as no others in our family of 4 have suffered like me.
I have studied psycho dynamic counselling and produced a thesis on the above but would like to explore more with an appropriate therapist. Psychiatry does not have funding or time to explore deep rooted issues in childhood.

Interesting read, working in an epidemiological incident project study on psychotic illness in LMIC country, which seeks to investigate the incidence and environmental risk factors amongst untreated cases of SSP. I have always been interested in a truly integrative bio psychosocial approach in understanding mental ill-health and keen follower of early intervention especially in resource constrained settings with little to no access to quality mental health services. Particularly, with the contemporary emphasis on childhood adverse events such as early trauma abuse and neglect as significant distal risk factors for psychosis in adolescence and early adulthood. So excited about such work aand article .

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